Article
Autologous matrix-induced chondrogenesis combined with autologous adipose stem cells (LIPO-Amic): surgical technique and an eighteen pilot patients report
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Authors
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Fabio Valerio Sciarretta
- Clinica Nostra Signora della Mercede, Rome, Italy
| Published: | October 23, 2017 |
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Outline
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Objectives: his pilot study describes the technical steps of the surgical technique and the preliminary outcomes of autologous matrix-induced chondrogenesis (AMIC) combined with autologous adipose tissue derived stem cells, defined as LIPO-AMIC, for the treatment of knee cartilage defects.
Methods: The LIPO-AMIC technique has been used for the treatment of ICRS degree III and IV focal cartilage defects in the knee. We extensively describe the surgical technique, step by step. Eighteen patients have been prospectively evaluated during two years both clinically and by MRI evaluation. Median age of the patients ( 5 females, 13 males) was 43,9 years (range 28-58). Defects were situated in the patella (n =11), in the femoral throclea (n = 5) and lateral femoral condyle (n = 2).
Results and Conclusion: Patient showed progressive significant clinical improvement of all the scores (Lysholm, Koos and VAS) as early as the initial 6 months follow-up after the LIPO-AMIC procedure and further increased values were noted till the last follow-up at 24 months postoperatively. MRI examination showed early subchondral lamina regrowth and progressive maturation of the repair tissue and moderate to complete filling of the defects.
The AMIC technique, introduced to overcome some shortfalls of microfractures, is the most described and studied one-step cartilage repair procedure in the literature, and has been determined to be safe and effective in treating full-thickness cartilage defects. The recent literature has clearly reported the regenerative capacity of adipose stem cells and has stated that adipose tissue can represent the ideal sourse of mesenchymal stem cells since the easiness of the lipoaspirate withdrawal, the mini-invasivity of the surgical procedure, the definite chondrogenic capacity and the abundant quantities of tissue and cells that can be harvested.
This pilot study clearly demonstrated the LIPO-AMIC technique we proposed to be feasible for the treatment of knee focal cartilage defects and to result in a statistically significant progressive clinical, functional and pain improvement in all treated patients, starting from the six months follow-up, earlier than what reported for the AMIC technique. The favourable results need to be confirmed in the longer term follow-up in order to determine the evolution of the repaired areas of the knees.
